Combination therapy: ICI + TKI
ICI: Immune Checkpoint Inhibition
TKI: Tyrosine Kinase Inhibition
AE: adverse event
Note: This is not a diagnosis/management tool for patients. Patients should always consult their treating specialist.
General principles
Types of AEs:
- most frequent overlapping AEs: fatigue, diarrhea, hepatotoxicity, endocrine toxicity and skin reactions
- see image below: overview of typical AEs with TKI and ICI, adapted from McGregor et al 2021 Cancer Treatment Reviews
Timing of AE:
- TKI: usually early (< weeks) after treatment initiation and quick to regress following dose hold
- ICI: unpredictable, can be months after treatment discontinuation
Management principles:
- according to CTCAE v5.0 grade and probable culprit
| grade 1 | mild: a- to paucisymptomatic | no intervention required |
| grade 2 | moderate: minimal symptoms | local/non-invasive treatment |
| grade 3 | severe: important symptoms, hospitalisation required | medical treatment |
| grade 4 | life threatening | urgent intervention |
- treatment options:
